LISA OMSITE EXAM QUESTIONS WITH COREECT ANSWERS LATEST 2025
Superior orbital fissure syndrome - Answers -Pupillary dilation via loss of parasymp along CN 3 (normally
pupillary constrictors)
-Paresis of CN 3, 4, 6 --> opthalmoplegia
-CN3 involvement --> paresis of levator palpebrae superiorus ms → ptosis and loss of superior palpebral
fold
-Neurosensory disturbance to CN5-1 with hyperesthesia of supraorbital and suprathrochlear ns.
-Loss of corneal reflex
-Proptosis from engorgement of ophthalmic vein and lymphatics
Orbital apex syndrome - Answers Superior orbital fissure syndrome + optic nerve involvement -->
changes in visual acuity
Post auricular ecchymosis - Answers High velocity trauma, basilar skull fx, hematoma or ecchymosis at
thin skinned mastoid region (post auricular) → hemotypanaum, B periorbital ecchymosis, posterior
pharyngeal ecchymosis or hematoma
Alignment for ZMC fx - Answers ZS is key point for fixation through biomechanical studies (Rohner 2002)
Approach from internal aspect of lateral orbit
LEAST cosmetic surgical approach for adolescent with orbital floor fx - Answers -Infraorbital incision:
direct and excellent exposure of orbital rim and floor with low complications
-Subciliary incision: more cosmetic
-Transconjuctival: cosmetically hidden
General order of tx of panfacial fx - Answers Expose all fx sites
Alleviate soft tissue entrapments
Establish soft and hard tissue reduction
Apply internal fixation
Soft tissue approximation
TX for acute dacryocystitis following trauma - Answers Incision and drainage of lacrimal sac
Administration of medicaments (systemic or topical decongestants)
Palliative care (warm compresses)
, NOT intubation of canaliculi and injection of dye
Causes of epiphora - Answers Epiphora: overflow of tears onto face from insufficient tear film drainage
from eyes so tears drain down face rather nasolacrimal system
Ectropion and entropion affects contact of inferior lacrimal punctum with tear fluid decreasing lacrimal
fluid flow
Traumatic telecanthus can also lead to alterations of tear flow and drainage in medial aspect of inferior
palpebral area and decrease lacrimal drainage through inferior canilculus
Nasolacrimal distruption from fx - Answers 17-21% following naso-ethmoidal fx, 3-4% following midface
fx, 0.2% nasal fx
Confirm CSF leak from frontal sinus fx - Answers High resolution CT cisternogram after administration of
intrathecal fluorescein
Horner's syndrome - Answers Disruption in sympathetic innervation to the ipsilateral maxillofacial region
→ constricted pupil, ptosis, anhidrosis
Retrobulbar hematoma - Answers Painful proptosis, progressive visual loss, restricted EOM, increased
IOP following sx to reduce zygomatic fx
Iridocyclitis - Answers Acute uveitis → traumatic anisocoria usually points towards the injury
Fat herniation through lid laceration - Answers Septum violation and mandates need for careful
evaluation for penetrating globe injury
Cartilaginous lacerations of ear - Answers Suture cartilage with slowly resorbable figure of eight sutures
Transcanthal wire in NOE fx - Answers Transcanthal wire secure canthal ligament and bony segment in
pretraumatic postion, soft tissues displace bone and ligament in anterior and inferior direction so place
wire in posterior and superior position
Class I hemorrhage - Answers 750mL --> HR<100, normal SBP, normal or increased PP, RR 14-20, UOP
>30mL/hr.
Class II hemorrhage - Answers 750-1500mL-->HR>100, normal SBP, decreased PP, RR 20-30, UOP 20-
30mL/hr.
Class III hemorrhage - Answers 1500-2000mL-->HR >120, decreased SBP, decreased PP, RR 30-40, UOP
5-15mL/hr.
Class IV hemorrhage - Answers >2000mL-->HR>140, decreased SBP, decreased PP, RR >35, UOP
negligible.
GCS - Answers Eye
Superior orbital fissure syndrome - Answers -Pupillary dilation via loss of parasymp along CN 3 (normally
pupillary constrictors)
-Paresis of CN 3, 4, 6 --> opthalmoplegia
-CN3 involvement --> paresis of levator palpebrae superiorus ms → ptosis and loss of superior palpebral
fold
-Neurosensory disturbance to CN5-1 with hyperesthesia of supraorbital and suprathrochlear ns.
-Loss of corneal reflex
-Proptosis from engorgement of ophthalmic vein and lymphatics
Orbital apex syndrome - Answers Superior orbital fissure syndrome + optic nerve involvement -->
changes in visual acuity
Post auricular ecchymosis - Answers High velocity trauma, basilar skull fx, hematoma or ecchymosis at
thin skinned mastoid region (post auricular) → hemotypanaum, B periorbital ecchymosis, posterior
pharyngeal ecchymosis or hematoma
Alignment for ZMC fx - Answers ZS is key point for fixation through biomechanical studies (Rohner 2002)
Approach from internal aspect of lateral orbit
LEAST cosmetic surgical approach for adolescent with orbital floor fx - Answers -Infraorbital incision:
direct and excellent exposure of orbital rim and floor with low complications
-Subciliary incision: more cosmetic
-Transconjuctival: cosmetically hidden
General order of tx of panfacial fx - Answers Expose all fx sites
Alleviate soft tissue entrapments
Establish soft and hard tissue reduction
Apply internal fixation
Soft tissue approximation
TX for acute dacryocystitis following trauma - Answers Incision and drainage of lacrimal sac
Administration of medicaments (systemic or topical decongestants)
Palliative care (warm compresses)
, NOT intubation of canaliculi and injection of dye
Causes of epiphora - Answers Epiphora: overflow of tears onto face from insufficient tear film drainage
from eyes so tears drain down face rather nasolacrimal system
Ectropion and entropion affects contact of inferior lacrimal punctum with tear fluid decreasing lacrimal
fluid flow
Traumatic telecanthus can also lead to alterations of tear flow and drainage in medial aspect of inferior
palpebral area and decrease lacrimal drainage through inferior canilculus
Nasolacrimal distruption from fx - Answers 17-21% following naso-ethmoidal fx, 3-4% following midface
fx, 0.2% nasal fx
Confirm CSF leak from frontal sinus fx - Answers High resolution CT cisternogram after administration of
intrathecal fluorescein
Horner's syndrome - Answers Disruption in sympathetic innervation to the ipsilateral maxillofacial region
→ constricted pupil, ptosis, anhidrosis
Retrobulbar hematoma - Answers Painful proptosis, progressive visual loss, restricted EOM, increased
IOP following sx to reduce zygomatic fx
Iridocyclitis - Answers Acute uveitis → traumatic anisocoria usually points towards the injury
Fat herniation through lid laceration - Answers Septum violation and mandates need for careful
evaluation for penetrating globe injury
Cartilaginous lacerations of ear - Answers Suture cartilage with slowly resorbable figure of eight sutures
Transcanthal wire in NOE fx - Answers Transcanthal wire secure canthal ligament and bony segment in
pretraumatic postion, soft tissues displace bone and ligament in anterior and inferior direction so place
wire in posterior and superior position
Class I hemorrhage - Answers 750mL --> HR<100, normal SBP, normal or increased PP, RR 14-20, UOP
>30mL/hr.
Class II hemorrhage - Answers 750-1500mL-->HR>100, normal SBP, decreased PP, RR 20-30, UOP 20-
30mL/hr.
Class III hemorrhage - Answers 1500-2000mL-->HR >120, decreased SBP, decreased PP, RR 30-40, UOP
5-15mL/hr.
Class IV hemorrhage - Answers >2000mL-->HR>140, decreased SBP, decreased PP, RR >35, UOP
negligible.
GCS - Answers Eye
